(960901) Form A1



ENGINEERING COUNCIL OF SOUTH AFRICA (10/01/2017) Form N1.1

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Private Bag X 691 Waterview Corner, 1st Floor,

BRUMA 2026 2 Ernest Oppenheimer Avenue

Tel: (011) 607-9500 Bruma Lake Office Park

Fax: (011) 622-9295 BRUMA

Email: engineer@ecsa.co.za Johannesburg

Office Use

Ref.:

Website: ecsa.co.za 2198

A P P L I C A T I O N F O R R E G I S T R A T I O N

IN THE SPECIFIED CATEGORY OF

REGISTERED FIRE PROTECTION SYSTEMS PRACTITIONER

NB: Please consult the enclosed Information Sheets (Sheets N1.1 and N1.2) before completing this Application.

1. General Information:

|Surname: |First Names: | |

| | |PHOTOGRAPH |

| | |(Passport-type. |

| | |Please paste - do |

| | |not staple) |

| | | |

| | |Alternatively, |

| | |insert |

| | |electronically in |

| | |JPEG or similar |

| | |format |

|Date of Birth: |Identity No: | |

| | | |

| |or | |

|*Race Group: |Asian |Black |Passport No. and Country: |Country of normal residence: | |

|Please tick the | | | | | |

|applicable block | | | | | |

| |Coloured |White | | | |

|Home Address: |Postal Address: |Name & Address of present Employer: |

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|Tel. No. (Home): |Title of Position held: |Tel. No. (Employer): |

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|Tel. No. (Work): (include area codes) | | |

| | |Fax No.: (include area codes) |

|Cell No.: | | |

| | | |

|E-mail: | |E-mail: |

*Completion of this section is necessary in order to accurately reflect equity statistics in terms of Government Policy.

2. Qualifications: (Highest level obtained per field)

|Educational Institution |Qualification |Attendance |Date of final |Office |

| | |from to |examination |use |

| | | | | |

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|NB: Kindly initial this page in the presence of a Commissioner of Oaths / Justice of Peace. |

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|Commissioner Of Oaths/ |

|Applicant: …………………………. Justice Of Peace: ……………………………………… |

-2- (10/01/2017) Form N1.2

3. Did you complete an Apprenticeship / Learnership: Yes No

|Trade: | | |

4. Specialised Courses in Fire Protection Systems and other related courses:

|Date of Course |Name of Course |

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5. Previous / Current Registration or Application Details: (eg. Professional Engineering Technician)

|Type |Category |Number |Date |

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|Previous Registration: | | | |

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|Current Registration: | | | |

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|Previous Application: | | | |

6. Membership of Engineering Institutes recognised in terms of the Act (See list): (Membership of Engineering Institutes or Associations not recognised may also be included. If more space is needed, please supply information separately.)

|Name of Association / Institute / Society |Membership grade |Number of years |Office held |

| |and date accepted | | |

| | | | |

| | | | |

7. Application Fee: (See item 7 of the Information Sheet)

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|My Application fee of R 00,00 (cheque) is enclosed herewith. (Not applicable, initial Reg Com) |

8. Referees: (At least one ECSA registered person)

|(1) |(2) |(3) |

| | | |

| | | |

|E-mail: |E-mail: |E-mail: |

|Tel No: |Tel No: |Tel No: |

9. Declaration:

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|I, (full names) |

|hereby apply for registration as a Registered Fire Protection Systems Practitioner and undertake to abide by all the provisions of the Engineering |

|Profession Act, 2000 (Act No. 46 of 2000) and any Rules published thereunder, including the Code of Conduct. I declare that Section 19(3)(a) of the |

|Act does not preclude me from registration. I solemnly declare that, to the best of my knowledge, all the information contained herein is true. |

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|Signature: __________________________ |

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|Sworn to/Affirmed before me at ___________________________ |

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|on this the ________ day of _____________________(month & year). |

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|Commissioner of Oaths/ |

|Justice of Peace: ……………………………………………… (Commissioner’s stamp) |

| Office Use Only | |

| | |

|Application fee: R ______________________ | |

| |(Council’s stamp) |

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|Received by: ________________________ Date: ______________________ | |

Engineering Council of South Africa (10/01/2017) Sheet N1.1

Information Sheet for Applicants Applying for

Registration as a Registered Fire Protection Systems Practitioner

This document briefly sets out the information required by the Registration Committee to assess applications.

A. General:

• All applicants should read, understand and provide all the information/documentation required in Sheets N1.1, N1.2, N2.1, N2.2, N4 and N5 of this application form. If the prescribed requirements are not met in the correct format, it is unlikely that applicants will be registered.

• The onus is on the Applicant to provide all the evidence for consideration of the Council. The evidence must demonstrate/show competency in accordance with the specification requirements of Policy Statement R2/1N: Acceptable Engineering Work for Registration of a Registered Fire Protection Systems Practitioner.

• Your application will only be considered by the Council if the following documents are submitted:

← Completed Application (Form N1.1 and N1.2).

← Certified copies of qualifications or courses.

← Completed Experience Reports (Forms N2.1), for each experience period, and the Summary of Experience Reports (Form N2.2), covering all technical experience with a minimum of 5 years required.

← Completed Developmental Questionnaire (Form N2.3), all questions answered.

← A completed Major Task Report (Form N2.4,) with actual resulting work schedule(s) and commissioning (inspection and test) report(s) for each equipment type applied for attached.

← Completed record of Inspection and Tests done over at least 2 years (Form N2.6)

← Referee Reports, each duly completed (Form N4.1 and N4.2).

← Completed Initial Professional Development Report (Form N5).

• In completing all forms use type or print clearly in black ink to ensure clear copying.

• Application fee must accompany the completed Application. NB. See item 7 below.

• Experience Reports, the Record of Test and Commissioning, the Developmental Questionnaire Report and the Major Task Report must be signed by the applicant and verified by an appropriate employer/supervisor. Should this not be possible, an affidavit to verify them, should be submitted.

• Your application for registration will only be considered when all referee reports have been received by the Council. If the referee reports do not reach the Council within a reasonable time, you will be notified accordingly. You will then be expected to contact the referees.

• If you are in doubt regarding any aspects please contact the Council’s offices.

• Each applicant will be advised of the Council’s decision as soon as possible, and no telephonic information regarding the progress of any application will be given.

• Please note that it is your responsibility to ensure that all reports reach Council's offices timeously.

B. The Application Form:

The following information is given to assist applicants to complete this form – the numbers refer to the equally numbered sections of the Application Form.

1. General Information: Ensure that all personal details are correct. A recent passport type photograph

of the applicant is required.

2. Qualifications:

• Original certified copies of your qualification certificate(s) must be submitted. (They must be certified by a Commissioner of Oaths or Justice of Peace. A Police Officer or Post Master will usually be able to help you.)

• Your documents must be submitted in English.

-2- (10/01/2017) Sheet N1.2

3. Apprenticeship / learnership:

If Yes, give trade and period.

4. Specialised Courses on Fire Protection Equipment Standards, Design, Installation, Site Inspections, Maintenance and Commissioning or related courses:

Specify all courses attended relating to Fire Protection Systems. Original certified copies of all certificates obtained must be submitted.

5. Previous / Current Registration or Application Details:

If you have previously applied for registration in any category or were previously registered but your registration was cancelled for any reason, please provide category and previous registration number in relevant block. If you are currently registered in another category, also complete the appropriate block.

6. Membership of recognised Engineering Institutes:

A list of associations recognised by Council for purposes of a reduction in annual fees is attached as Addendum A. Proof of current membership of such association will qualify you for a reduction in your annual fee should your application be successful. Memberships of non-recognised engineering institutes should also be given.

7. Application and Annual Fees:

Only cheques or proof of direct payment must accompany your application form, as no cash or postal orders will be accepted. If you do not have a cheque account, you may deposit cash at any Standard Bank into ECSA’s account. Please contact our Accounts Department at (011) 607-9530/1/2/3 or Reception at (011) 607-9500 to obtain our banking details. Alternatively you may make payment (1) via the internet, or (2) you may ask your bank for a bank cheque to be made out to ECSA, (3) contact your bank’s telephone banking division to make payment into ECSA’s account or (4) by credit card by phoning our Accounts Department. When making the deposit please ensure that your name and initials entered in the field named “Depositor’s name or reference number” and attach a copy of the proof of deposit to your application form. Refer to separate sheet regarding fees payable, visit ECSA’s website at , click on “Finance” or contact the Council’s offices at (011) 607-9500 to determine the current fee.

8. Referees:

Each applicant must, with the permission of the persons concerned, supply the Council with the names and addresses of a minimum of three referees, who have personal knowledge of the applicant's work. At least one referee must be registered with ECSA as either a Registered Fire Protection systems Practitioner, a Professional Engineering Technician, a Professional Engineering Technologist, Professional Certificated Engineer or a Professional Engineer, of which one should be a direct supervisor.

Referees may be chosen in the following order of preference:

(a) Immediate supervisor

(b) Mentor

(c) Indirect supervisor

(d) Employer

(e) Colleague at a higher level involved with your work (not more than one out of three referees).

(f) Colleague at a higher level not directly involved with your work (not more than one out of three referees).

(g) Client

Use Form N3 for formal correspondence with each referee, and enclose copies of the referee report (Form N4.1 and N4.2) and the guideline for referees (Sheet N4). It is suggested that you provide each referee with an addressed envelope with prepaid postage for the referee to forward the report direct to the Council.

9. Declaration: Section 19(3)(a) of the Engineering Profession Act, 2000 (Act No. 46 of 2000) reads:

“Despite subsection (2), the Council may refuse to register an applicant -

(i) if the applicant has been removed from an office of trust on account of improper conduct;

(ii) has been convicted of an offence in the Republic, other than an offence committed prior to 27 April 1994 associated with political objectives, and was sentenced to imprisonment without an option of a fine, or, in the case of fraud, to a fine or imprisonment or both;

(iii) if the applicant has, subject to paragraph (b), been convicted of an offence in a foreign country and was sentenced to imprisonment without an option of a fine, or, in the case of fraud, to a fine or imprisonment or both;

(iv) if the applicant is declared by the High Court to be of unsound mind or mentally disordered, or is detained under the Mental Health Act, 1973;

(v) for as long as the applicant is disqualified from registration as a result of any punishment imposed on him or her under this Act;

(vi) if the applicant is an unrehabilitated insolvent whose insolvency was caused by his or her negligence or incompetence in performing work falling within the scope of the category in respect of which he or she is applying for registration.”

Note that your application must be sworn to or affirmed before a Commissioner of Oaths or a Justice of Peace. Your attention is drawn to the initialling required at the bottom of the first page of the Application Form.

Engineering Council of South Africa (10/01/2017) Form N2.1

EXPERIENCE REPORT

REGISTERED FIRE PROTECTION SYSTEMS PRACTITIONER

Page No. of

Surname and Initials:

Specific equipment type applicable:

(Sprinkler systems, high velocity spray systems, medium velocity spray systems, high, medium or low expansion foam systems, mist systems)

Consult the enclosed Information Sheet (Sheet N2) before completing this report.

|Period No: |Date from: |Your Title or Function: |No. of | |

| |to: | |years: | |

|Employer’s Name and address: |

|Supervisor’s Name, Title of Position held and address: | |

| |Supervisor’s |

| |Signature: |

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|ECSA Registration No: |Date: |

|(Please do not exceed 200 words per period) |

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Signature of Applicant: _________________________________ Date: _______________

Engineering Council of South Africa (10/01/2017) Form N2.2

SUMMARY OF EXPERIENCE REPORTS : REGISTERED FIRE PROTECTION SYSTEMS PRACTITIONER

Surname and Initials:

Specific equipment type applicable:

(Sprinkler systems, high velocity spray systems, medium velocity spray systems, high, medium or low expansion foam systems, mist systems)

First complete a Form N2.1 for each period.

| |Dates (inclusive) |Number of | | | |

|Period No: | |years and months |Employer |Post held |Subject and type of work |

| |From: To: | | | | |

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|Total years, months: | |

Signature of Applicant: _________________________________________ Date:

Engineering Council of South Africa (10/01/2017) Form N2.6

RECORD OF COMMISSIONING (INSPECTION AND TESTS) CARRIED OUT OVER A PERIOD OF AT LEAST 2 YEARS:

REGISTERED FIRE PROTECTION SYSTEMS PRACTITIONER

Surname and Initials:

Specific equipment type applicable to your registration:

(Sprinkler systems, high velocity spray systems, medium velocity spray systems, high, medium or low expansion foam systems, mist systems)

| |Dates (inclusive) |Specific Equipment Inspected and Tested |Owner of Fire Protection |Serial Number of Fire |Type of test (eg. |Standard if applicable|Final Result of Inspection and Test |

|Load Test No:| | |System Tested |Protection Equipment Tested |Rou-tine, etc) | | |

| |From: To: | | | | | | |

|1 | |

| |Name: | |Technical Qualifications: | |

|B. |Tick off (() the specific equipment type(s) applicable to your registration application: |

| |Sprinkler systems | |Design | |

| |High velocity systems | |Calculation | |

| |Medium velocity systems | |Installation supervision and management | |

| |Foam systems (high, medium, low) | |Commissioning | |

| |Water mist systems | |Maintenance | |

| |Pumped water/foam supplies | | | |

| | | | | |

|C. |INSTRUCTIONS |

| |Fire Protection Systems Practitioner must be conversant with the underpinning technical information on the fire protection system equipment type |

| |ticked off above. |

| |Use this form to answer each question below in a short paragraph of maximum 100 words. The answer must be your own work and not a copy of a previous |

| |successful application submitted by others, or a generic copy used by all the applicants in your company. Internet and text book information must be |

| |interpreted, and not just copied. |

| |Answers must include reference to practically defined examples in the work place demonstrating how the competencies were satisfied. (Additional |

| |supporting evidence e.g. completed test reports, maintenance schedules, etc. may be attached). |

| |The applicant must sign the completed questionnaire and also obtain a signature from his/her supervisor. |

| |The applicant may be invited to an interview to expand and/or confirm this questionnaire. |

| |Submit the completed forms with your application form. |

|DEVELOPMENTAL QUESTIONNAIRE REPORT MAINTAINING: |

| |Demonstrate knowledge of maintaining the systems |

|Item |Question Requirement |Answer Statement |

| |Different types of water supply systems are identified and | |

| |described in terms of their applicability to the system. | |

| |Different systems are described in terms of their main | |

| |functions and maintenance procedures. | |

| |For water based systems, the interconnection between different| |

| |systems is described in terms of their importance in fire | |

| |protection. | |

| |Maintenance tasks and relevant equipment are described in | |

| |accordance with accepted industry standards. | |

| |Maintenance intervals are identified in accordance with | |

| |manufacturer specifications. | |

| |Safety requirements are described as they relate to specific | |

| |zones. | |

| |Describe how a particular system is tested |

|Item |Question Requirement |Answer Statement |

| |The functionality of components and ancillary devices are | |

| |confirmed to be in accordance with design criteria. | |

| |The water supply system is tested in accordance with | |

| |manufacturer specifications. | |

| |For pumped water supplies system is tested in accordance with| |

| |accepted codes of practice. | |

| |For smoke control systems, the interconnection with sprinkler| |

| |systems are tested in accordance with manufacturers | |

| |specifications. | |

| |Tests are conducted without causing damage to property or | |

| |equipment. | |

| |Work is conducted in accordance with legislative safety | |

| |requirements. | |

| |The system is confirmed to be operational in accordance with | |

| |design criteria. | |

| |Describe how to repair the particular system |

|Item |Question Requirement |Answer Statement |

| |Faults with the system are identified and repaired or | |

| |reported in accordance with design criteria. | |

| |Replacement components are identified in terms of | |

| |applicability and availability. | |

| |Components are replaced in accordance with manufacturer | |

| |specifications. | |

| |Recommendations are made in relation to additions and | |

| |rectifications. | |

| |Describe how to report maintenance procedures |

|Item |Question Requirement |Answer Statement |

| |The system is confirmed to be in accordance with the design. | |

| |Relevant documentation is completed in accordance with | |

| |legislative requirements. | |

| |Documentation is distributed in accordance with legislative | |

| |requirements. | |

| |The end user is briefed on the operation of the system in | |

| |accordance with system requirements and user | |

| |responsibilities. | |

|DEVELOPMENTAL QUESTIONNAIRE REPORT INSTALLING: |

| |Demonstrate knowledge of the components of the equipment to be installed. |

|Item |Question Requirement |Answer Statement |

| |The basic chemistry of combustion is described in accordance | |

| |with accepted fire industry standards. | |

| |Components are identified and the purpose of each component | |

| |is described in terms of its main uses and limitations in the| |

| |system. | |

| |Consequences of incorrect installation are explained in terms| |

| |of the effect on the system. | |

| |Different fire risk zones or occupancy classifications are | |

| |described in accordance with the relevant standards. (For | |

| |fixed fire protection systems only, the interconnections | |

| |between these systems and other fire protection measures are | |

| |explained in relation to their importance). | |

| |Static electricity is described in terms of the risks | |

| |involved and precautionary measures that may be taken. | |

| |State how you prepare to install components making up the installation |

|Item |Question Requirement |Answer Statement |

| |Building plans and schematic diagrams are interpreted to | |

| |identify location of components. | |

| |Tools, equipment and components required for the installation| |

| |are identified and prepared for use in accordance with the | |

| |given design. | |

| |The installation task is confirmed with relevant authorities | |

| |in accordance with workplace procedures. | |

| |Permission to install the system is confirmed with relevant | |

| |personnel in accordance with relevant safety legislation. | |

| |Describe how to install the components making up the system |

|Item |Question Requirement |Answer Statement |

| |Components are installed in accordance with manufacturer | |

| |specifications. | |

| |Components are positioned in accordance with contract | |

| |documentation. | |

| |Fixed fire protection systems are used in accordance with the| |

| |relevant legislation. | |

| |Work is conducted in accordance with relevant health and | |

| |safety legislation. | |

| |Work is conducted in accordance with agreed time schedules. | |

| |Tools and equipment are used in accordance with their design.| |

| |Power supply circuit breakers are labelled in accordance with| |

| |health and safety legislation. | |

| |Describe how the system is tested |

|Item |Question Requirement |Answer Statement |

| |Support and erection of piping where applicable is/are | |

| |checked in accordance with manufacturer specifications. | |

| |Test equipment is used in accordance with its design.) | |

| |Work is conducted in accordance with relevant health and | |

| |safety legislation. | |

| |Relevant documentation is completed in accordance with | |

| |legislative requirements. | |

| |Describe how the system is designed |

|Item |Question Requirement |Answer Statement |

| |The relationship between known and proven standards for the | |

| |fixed fire protection system in order to comply with | |

| |legislative requirements. | |

| |Manufacturer’s literature is used for guidance and is | |

| |followed within the design parameters. | |

| |Assessment of the risk under design is to be reviewed in | |

| |accordance with relevant documentation. | |

| |Design is to encompass the very latest information available | |

| |in order for the system to be relied upon. | |

| |Design is a product of given calculation parameters. | |

|DEVELOPMENTAL QUESTIONNAIRE REPORT COMMISSIONING: |

| |Demonstrate knowledge of commissioning systems |

|Item |Question Requirement |Answer Statement |

| |The purpose of commissioning the system is explained in terms| |

| |of meeting design and client acceptance criteria. | |

| |Limitations to commissioning are described in accordance with| |

| |relevant health and safety legislation. | |

| |Test methods are described in accordance with the relevant | |

| |legislation/standard. | |

| |Zoning of fixed fire protection systems is described in | |

| |relation to the effect on the particular extinguishing | |

| |systems. | |

| |The link between detection or inert gas extinguishing systems| |

| |and fixed fire protection systems is explained in relation to| |

| |the overall design criteria. | |

| |Consequences of non-compliance of the system are explained in| |

| |terms of the potential impact to safety and loss control. | |

| |Show your knowledge on how to activate and test systems |

|Item |Question Requirement |Answer Statement |

| |The system is initialised and checked for operation in | |

| |accordance with design criteria. | |

| |Operation of ancillary devices are confirmed to be in | |

| |accordance with design criteria. | |

| |Faults are rectified in accordance with manufacturer or | |

| |design specifications. | |

| |Information for a suitable fixed fire protection installation| |

| |is obtained from the client and designed in accordance with | |

| |known and proven specifications. | |

| |Test equipment is used in accordance with its design | |

| |approval. | |

| |Describe how you inspect systems during site erection |

|Item |Question Requirement |Answer Statement |

| |The installation is confirmed to be in accordance with the | |

| |building plans. | |

| |The installation is checked for conformance to the design | |

| |drawings. | |

| |The water supply is confirmed to be correct in accordance | |

| |with known and proven design criteria. | |

| |The system is confirmed to meet engineering and safety | |

| |requirements. | |

| |Describe how you certify the system |

|Item |Question Requirement |Answer Statement |

| |The system is confirmed to be in accordance with the approved| |

| |design. | |

| |Relevant documentation and manuals are completed in | |

| |accordance with legislative requirements. | |

| |Documentation is distributed in accordance with legislative | |

| |requirements. | |

| |The end user is briefed on the operation of the system in | |

| |accordance with system requirements and user | |

| |responsibilities. | |

Signature of Applicant: ____________________________Date: ________________

Signature of Mentor / Supervisor: _____________________________

Name of Mentor/Supervisor printed: __________________ Tel. No.: ___________

Engineering Council of South Africa (10/01/2017) Form N2.4

Major Task Report

IMPORTANT NOTE: Use this form to report in maximum 100 words per item on a major design and calculation installation, commissioning and maintenance task carried out by you on any one of the specific types of equipment listed below. THE RESULTING ACTUAL WORK SCHEDULE AND COMMISSIONING (OR INSPECTION AND TEST) REPORT MUST BE ATTACHED. IF ADDITIONAL SPECIFIC EQUIPMENT TYPES ARE APPLIED FOR, SIMILAR ACTUAL WORK SCHEDULE AND COMMISSIONING (OR INSPECTION AND TEST) REPORT MUST ALSO BE ATTACHED. Note that the Major Task Report need not be repeated for each equipment type, only the attachments.

Name of Applicant:

Specific equipment type(s) applicable to your registration:

(Sprinkler systems, high velocity spray systems, medium velocity spray systems, high, medium or low expansion foam systems, mist systems)

Consult the Information Sheet (Sheet N2) before completing this report.

|Brief Description of Task: (Less than 20 | |

|words) | |

|Date of Task: | |

|Outcome 1: Define, investigate and analyse a task to be done in your work environment: |

|State how you interpreted the task | |

|instruction to the satisfaction of the | |

|client (acceptance criteria). | |

|Describe how you analysed, obtained and | |

|evaluated further clarifying information, | |

|and if the instruction was revised as a | |

|result. | |

|Outcome 2: Design or develop a solution to problems encountered in your work: |

|Describe how you developed and/or analysed | |

|alternative solutions to do the task. | |

|Impacts checked. | |

|State what the final solution to perform | |

|the task was, client in agreement. | |

|Outcome 3: Applying theory from your education in performing tasks: |

|State what educational knowledge you used | |

|to perform the task. | |

|State what standard procedures you used to | |

|do the design or task and on what theory | |

|these were based. | |

|Outcome 4: Task management embodied in your work: |

|State how you managed yourself, priorities,| |

|processes and resources in doing the task | |

|(bar chart). | |

|Describe your role and contribution in the | |

|task team. | |

|Outcome 5: Communicate clearly with others in the course of your work: |

|State how you reported back after | |

|completion of the task. | |

|State how you issued instructions to | |

|entities working on the task. | |

|Outcome 6: Environmental and social impact of your work: |

|Describe the social and environmental | |

|impact of this engineering activity. | |

|State how you communicated mitigating | |

|measures to affected parties | |

|Outcome 7: Meet legal and regulatory requirements of your work (Health and Safety): |

|List the major laws and regulations | |

|applicable to this particular activity. | |

|State how you obtained advice in doing risk| |

|management for the task. | |

|Outcome 8: Conduct activities ethically in doing your work: |

|State how you identified ethical issues and| |

|affected parties and their interest. | |

|Confirm that you are conversant and in | |

|compliance with ECSA’s Code of Conduct. | |

|Outcome 9: Exercise sound engineering judgement in doing your work: |

|State the factors applicable to the task, | |

|their interrelationship. | |

|Describe how you foresaw task consequences | |

|and evaluated situations in the absence of | |

|full evidence. | |

|Outcome 10: Be responsible for making decisions on part or all of your work activities: |

|State how you applied theory to justify | |

|decisions taken in doing tasks. | |

|State how you took responsible advice on | |

|any matter falling outside your own | |

|education and experience. | |

|Describe how you took, responsibility for | |

|your own work by evaluating your work | |

|output and revising any shortcoming. | |

|Evidence of your competency development plan and independent learning ability must be given in the Initial Professional Development Report, Form N5. |

Signature of Applicant: ____________________________Date:

Signature of Mentor / Supervisor: _____________________________

Name of Mentor/Supervisor printed: Tel. No.:

Engineering Council of South Africa (10/01/2017) Sheet N2.1

Information Sheet for completion of the

Experience Reports/ Developmental Questionnaire Report/ Major Task Reports

1. Your application for registration as a Registered Fire Protection Systems Practitioner (Reg. FPSP) must be accompanied by the Experience Reports (Forms N2.1) in which your experience in the fire engineering industry from the date of obtaining the highest technical qualification to the date of application is recorded in chronological order and typed or printed in black ink. If you have a NQF 5 level qualification, a minimum period of five years’ experience in fire protection systems installation, commissioning and maintenance, of which at least two years must be in a position of responsibility, under the necessary supervision, is required.

• Use a separate form for each experience period and approximately 200 words per form.

• Number the periods in chronological order, which may not overlap.

• Cover the period from obtaining the highest education/qualification to the date of application.

• Provide full details of fire protection systems installation, commissioning and maintenance work that you have performed, such as supervising, modifications, fault investigations, etc. done during each period indicating your personal role and level of responsibility. This work will typically be of a higher level than artisan/journeyman or learnership work.

An experience period ends when:

▪ your work environment has changed, eg. when a major task or project has been completed;

• your type of work has changed;

▪ your responsibilities or level of function have changed (for instance, as in a promotion);

• you have changed employer;

• your experience is interrupted (for instance by study or prolonged illness).

2. The experience periods and periods of interruption must also be noted in the Summary of Experience Reports (Form N2.2). Ensure that each Form N2.1 is signed (verified) by your relevant supervisor or employer and signed by yourself. If you cannot obtain the supervisor's signature, or if you are the owner of your own business, please annotate accordingly in the appropriate block and submit an affidavit to the effect that the information provided is true and correct, and give the reasons why the supervisor signature cannot be obtained. Note that the Commissioner of Oaths must stamp and sign each experience report that is not signed by the supervisor.

A record of actual inspections and tests done by yourself, under supervision, must be provided separately using Form N2.6. Ensure that this form is signed by your mentor or supervisor and yourself.

3. The Experience Report (Form N2.1) must be set out in a way that clearly shows fire protection system knowledge and skills applied. It is incumbent on applicants to select and describe tasks, which show their level of fire engineering knowledge and experience and clearly illustrates your own role and strategies devised to make these tasks successful.

4. The functions described must address your involvement and responsibility in fire protection systems work. They should refer to your exact participation in:

• Installation, commissioning and maintenance.

• Specific equipment type used: fire alarm and detection, passive fire protection, aerosol fire extinguishing, water sprinklers, foam fire extinguishing, electrical smoke control, mechanical smoke control, mechanical fixed gaseous fire extinguishing, electrical fixed gaseous fire extinguishing.

• Monitoring, manufacturing, economics, resources (including human resources) management.

5. Calculations, reports, sketches, schedules, test certificates, commissioning reports and any other relevant documentation to support written submissions should be attached.

6. Use Form N2.3, Developmental Questionnaire Report, answering all the questions requirements, to demonstrate the basic knowledge developed on the equipment that you are working on. The answers must be uniquely formulated from your personal experience in the workplace, but supplementary information can be obtained from other sources, if required. Your supervisor must sign the report.

7. Use Form N2.4 to submit a single major installation, commissioning and maintenance task report. The task must be of a nature that is representative of the work that you have done illustrating your own role and strategies devised to make the task successful. The actual work schedule and commissioning (or inspection and test) report resulting from such tasks must be attached for each type of equipment applied for. (Fire alarm and detection, passive fire protection, aerosol fire extinguishing, water sprinklers, foam fire extinguishing, electrical smoke control, mechanical smoke control, mechanical fixed gaseous fire extinguishing, electrical fixed gaseous fire extinguishing). Your supervisor must sign the report.

Engineering Council of South Africa (10/01/2017) Sheet N2.2

Work Schedule Report: You should not use third party tense (use I not we) and the work schedule must include your engineering inputs in at least the following aspects:

• Identify activities required and the desired outcome (e.g. inspection and test after installation/ commissioning/ maintenance, and provide report)

• Compile or source an activity list used to undertake the major task (inspection and test)

• Provide a list of inspection or test equipment needed to undertake the task (test) i.e. electronic measuring equipment, pressure gauges, etc.

• Compile or source a project time frame (bar chart)

• A guideline of your intended report to be submitted after the inspection and test

• Your authorisation or request document to do the inspection and test after installation/ commissioning/ maintenance.

• A short description of how you prepare the work area prior to conducting work, detailing moral constraints, and how you would limit public access

• A short description of the physical work, with important planning inspection criteria on safety criteria highlighted

• How fire protection systems and the site are intended to be returned to service, and how documents generated will be administrated

Commissioning, Inspection and Test Report: You are required to submit reports of actual commissioning, inspection and testing you have conducted under the guidance of a registered person. You should include the following where applicable on conclusion of your commissioning:

• The test certificate must show the specific equipment commissioned, the test equipment used and the test result. The applicant, his/her supervisor and the customer must have signed the certificate.

• Commissioning report and test certificates were generated using all available data, covering all aspects and test requirements to stakeholders needs timeously.

• That any deficiencies defects or hazardous conditions are noted (or listed as nil), corrected if necessary and reported to all stakeholders.

• Compliances / Non compliances and or findings are clearly communicated to all stakeholders.

• Any suggestions to improve testing efficiency listed.

(10/01/2017) Form N3

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ENGINEERING COUNCIL OF SOUTH AFRICA

SUID-AFRIKAANSE RAAD VIR INGENIEURSWESE

Private Bag X 691 ( BRUMA ( 2026

Tel: (011) 607-9500

Fax: (011) 622-9295

E-mail: engineer@ecsa.co.za

Website: ecsa.co.za

REGISTERED FIRE PROTECTION SYSTEMS PRACTITIONER

Name of Referee Date

Address:

Dear Sir

I have applied to the Engineering Council of South Africa for Registration as a Fire Protection Systems Practitioner and hereby request you to provide the Council with your evaluation of my experience and capabilities, on the basis of your personal knowledge thereof.

Please use the attached Forms N4.1 & N4.2 and consult the guideline for referees (Sheet N4).

In making this request to you I acknowledge that the information which will be supplied by you to ECSA is of a confidential nature and that I have no right thereto.

Your co-operation and early despatch of the document direct to the Council would be appreciated, as it would expedite the processing of my application.

Thank you in advance for your co-operation.

Yours faithfully

………………………………………

Signature of Applicant Name of Applicant (Please print)

Address:

Postal Code

Telephone No: Cell No:

CONFIDENTIAL (10/01/2017) Form N4.1

REFEREE REPORT : REGISTERED FIRE PROTECTION SYSTEMS PRACTITIONER

Please complete this form using type or print in black ink, after consulting the attached guideline (Sheet C4).

The Engineering Council of South Africa agrees that it owes a duty of confidence

to all referees in terms of the Promotion of Access to Information Act, 2000

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|Name of Applicant: |

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|Address: |

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1. General Information:

(a) My personal knowledge of the applicant's engineering experience extends from

to (month and year closely as possible).

b) My association with the applicant was that of:

|Mentor | |Colleague | |

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| | | | |

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-2- (10/01/2017) Form N4.2

2. Assessment of Applicant

a) Based on my personal knowledge of the applicant of whom information has been supplied above, assess his/her level as follows:

| |Very low |Low |Satisfactory |High |Very High |Unknown |

|Ability to comprehend and grasp system standards | | | | | | |

|and codes and through these develop solutions to | | | | | | |

|FPSP problems | | | | | | |

|Ability to comprehend and apply FPSP knowledge in | | | | | | |

|practice | | | | | | |

|Ability to manage part or all of one or more FPSP | | | | | | |

|activities | | | | | | |

|Ability to communicate clearly with others | | | | | | |

|Ability to recognise the foreseeable social, | | | | | | |

|cultural and environmental effects of FPSP | | | | | | |

|activities | | | | | | |

|Ability to meet legal and regulatory requirements | | | | | | |

|protecting the health and safety of persons and | | | | | | |

|their environment | | | | | | |

|Ability to conduct FPSP activities ethically | | | | | | |

|Ability to exercise sound FPSP engineering | | | | | | |

|judgement | | | | | | |

|Ability to accept responsibility for making FPSP | | | | | | |

|decisions | | | | | | |

|Ability to undertake independent FPSP learning | | | | | | |

|activities | | | | | | |

(b) Additional comments: (must be completed if assessment is “Very Low”, “Low”, or “Unknown)

3. Referee’s Recommendation:

I regard the applicant competent to be registered as a Fire Protection Systems Practitioner:

|Yes |No (Do not register) |Defer |Do not know |

| | | | |

5. Declaration by Referee: I hereby confirm that I am conversant with the Council’s requirements for registration as set out in Policy Statement R2/1N as well as the instructions on this referee report, and that I am prepared to substantiate my view expressed herein at an interview, should the Council require me to do so. I also confirm that I submit this information to ECSA on the understanding that it will be treated as confidential.

Name of Referee: Title of Position held:

Qualifications:

ECSA Registration Category: Registration No:

e.g. Technician, Engineer, RegFPSP, etc.

Employer: Tel/Cell. No:

Signature of Referee: ________________________________________ Date:

Please post to:

( The Chief Executive Officer ( Engineering Council of South Africa

Private Bag X691 ( BRUMA ( 2026

Engineering Council of South Africa (10/01/2017) Sheet N4

REFEREE GUIDELINE

for the Completion of the Referee Report

Registered Fire Protection Systems Practitioner

1. COMPETENCY OF A REGISTERED FIRE PROTECTION SYSTEMS PRACTITIONER

Registered Fire Protection Systems Practitioners are persons who show knowledge on the standards, codes and rules for the assessment, design, calculation, installation, site inspection during erection, commissioning and planned maintenance on fire engineering equipment by applying known and novel technology in the specified category applicable to one or more of the following:

Sprinkler installations;

Foam based installations;

High velocity spray systems;

Medium velocity spray systems;

Mist systems;

They understand fundamental principles underlying the specific techniques and are competent to do design and calculations using mathematical formulas. They usually operate within standards, codes and procedures. Through their understanding of specific equipment and processes used they contribute to technical, financial, managerial and legal aspects of teams/projects. Their autonomy and competence enable evaluation, consultation, implementation and the taking of specific responsibility in their field of expertise.

2. IMPLICATION OF REGISTRATION

The individual subscribes to and will adhere to the Professional Code of Conduct of the Act. As such he/she is required to accept legal responsibility for the soundness of the work executed and thereby affording protection to the public.

3. COMPLETING THE REFEREE REPORT

3.1 Aim

The referee report is a necessary and supplementary document to the applicant’s application for registration as a Registered Fire Protection Systems Practitioner with ECSA. The aim is to convey to the Council, on a confidential basis, the personal knowledge, which the referee or the employer has of the applicant, and in the process to make a reasoned evaluation of the applicant’s capabilities.

3.2 Motivation

It is necessary that the referee or employer be able to clearly and strongly motivate his/her opinion in respect of the applicant’s readiness for registration. The referee must, when supplying reasons, consider the minimum legal registration requirements.

When signing the referee report, referees declare that they are acquainted with Council’s Policy Statement R2/1K and that they are prepared to be interviewed by the Council to substantiate their viewpoint, should Council require them to do so.

3.3 Evaluation

The referee must carefully evaluate the applicant’s capabilities. An evaluation of the candidate’s ethical and professional competence is required.

Referees should have a personal knowledge of an applicant and his/her work and they should be able to give a professional opinion on his/her specific engineering ability, level of specific engineering responsibility and professional conduct during the period of time of their knowledge of the applicant's activities.

The referee must carefully evaluate the applicant’s capabilities and correctly and accurately complete the report as Council attaches great value to the information, which is supplied by the referee.

4. GENERAL

The Referee Report should be returned directly to ECSA by the referee. Referees are requested to have their assessments typed or to complete the report in legible block letters using black ink to ensure clear copying, since written assessments are frequently not very legible and to the detriment of the applicant.

5. CONFIDENTIALITY

ECSA undertakes to protect the confidentiality of all the information received from the referee.

Engineering Council of South Africa (10/01/2017) Form N5

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|Registered Fire Protection Systems Practitioner |

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|INITIAL PROFESSIONAL DEVELOPMENT REPORT (IPD) |

| |

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|See enclosed Information Sheet (Sheet K5) |

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|Name: |

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|Discipline: |

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|Itemise courses, workshops, conferences, symposia or congresses attended. |

|List these under the separate headings of engineering, management and computer courses. |

| | |Dates |Duration in |For use of |

|Name or subject of item |Course Provider |attended |hours |Assessor |

|Engineering Courses |

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|Management Courses |

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|Computer Courses |

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__________________________________ ______________________

Signature of Applicant Date

Engineering Council of South Africa (10/01/2017) Sheet N5

Information Sheet

for completion of the

Initial Professional Development Report (Form N5)

All persons applying for registration as a Registered Fire Protection Systems Practitioner must complete this form.

1. Initial Professional Development is defined as the ongoing studies and development of engineering knowledge required to keep abreast of new technologies. The Registration Committee aims to gauge to what extent applicants kept abreast with engineering and technical developments in their fields of expertise subsequent to obtaining their highest formal qualifications.

2. Details of additional engineering courses and engineering subjects done are required.

3. List other engineering courses, seminars, conferences, symposia, workshops etc. that were attended. Please provide dates [year] attended and duration of the course in days or hours. Please indicate whether you were required to sit a written examination at the conclusion of other engineering courses. Also provide detail of papers delivered at engineering seminars, conferences, symposia, workshops, overseas study tours, etc.

4. It is not required that copies of certificates relating to relatively minor seminars or courses form part of the application.

(10/01/2017)

Before the Application Form is submitted to the Engineering Council

please make sure that the following points have been checked and included:

1. Application fee of R 00,00 (Not applicable, initial reg. com.).

2. First page of Application Form is initialled by the applicant and Commissioner of Oaths.

3. Second page of Application Form is signed by applicant, signed and stamped by the Commissioner of Oaths.

4. The names of a minimum of three referees have been given.

[The referee reports (Forms N4.1 & N4.2) must be sent under separate cover and at least one of the people chosen must be registered as a Professional Engineer, a Professional Engineering Technologist, a Professional Engineering Technician, a Professional Certificated Engineer or a Registered Fire Protection Systems Practitioner. Referee reports from your supervisors are preferable, and they should have played some mentoring or supervisory role in your career development.]

5. A photograph has been attached to Application Form N1.1.

6. Experience Reports covering ALL the experience gained completed on the forms provided (Forms N2.1 and N2.2). (Photocopies of the blank forms may be made.)

7. Signatures of applicant on each Experience Report.

8. Signatures of employer on each Experience Report.

9. Summary of the record of the applicant’s experience in the fire systems equipment industry for a period of at least 5 years. (Form N2.2).

10. If the applicant has his own business or signatures are unobtainable, the experience report must be accompanied by a Sworn Affidavit providing reasons for not obtaining the signature and stating that the information is true and correct, i.e. the Commissioner of Oaths must stamp and sign each experience report form.

11. Answers to the Developmental Questionnaire Report with all the questions requirements answered (Paragraph 6 of Sheet N2.1), signed by the applicant and his/her supervisor.

12. Major Task report (paragraph 7 of Sheet N2.1) indicating the applicant’s own contribution/role and responsibility in the task submitted, signed by the applicant and his/her supervisor. THE ACTUAL WORK SCHEDULE(S) AND TEST REPORT(S) MUST BE ATTACHED FOR EACH TYPE OF EQUIPMENT APPLIED FOR

13. Record of Inspection and Tests done by the applicant over the last two years (Form N2.6), signed by a supervisor.

14. Details of your Initial Professional Development (IPD) (using Form N5).

15. Certified copies of certificates, diplomas, degrees, etc.

16. Proof of membership of Institutions must be provided, where applicable.

If any of the above, do not accompany the Application Form,

your Application will be held in abeyance until receipt of the information.

Addendum A

(27 March 2012)

Voluntary Associations

recognised in terms of section 25(3) of the

Engineering Profession Act, 2000 (Act No. 46 of 2000)

These Voluntary Associations applied for recognition in terms of section 36(1) of the Engineering Profession Act, 2000 (Act 46 of 2000) and were recognised by the Council in terms of Section 25(3) of the above Act.

One of the benefits of recognition is that registered members of a Recognised Voluntary Association (Categories A and B only) enjoy partial exemption from payment of their ECSA annual fees. Expiry date for these voluntary associations below is five (5) years from the date of recognition. These Acronyms appear in alphabetically order for ease of reference.

| |Category A |

| |Acronym |Name |Reference |Date |

|No | | |Number |Recognised |

|2 |AMMSA |Association of Mine Managers of South Africa |VA A0031 |24 January 2007 |

|3 |AMRE |Association of Mine Resident Engineers |VA A0032 |30 November 2007 |

|4 |CEASA |Clinical Engineering Association of South Africa |VA A0040 |26 August 2010 |

|5 |COET |The Chamber of Engineering Technology |VA A0001 |19 October 2010 |

|6 |CSSA |Concrete Society of Southern Africa |VA A0019 |11 August 2011 |

|7 |ICMEESA |Institution of Certificated Mechanical and Electrical Engineering |VA A0002 |24 November 2010 |

|8 |IEEE |Institute of Electrical and Electronic Engineers South African Section |VA A0036 |12 June 2008 |

|9 |IMESA |Institution of Municipal Engineering of Southern Africa |VA A0003 |14 April 2011 |

|10 |IPET |Institute of Professional Engineering Technologists |VA A0004 |19 October 2010 |

|11 |LIASA |Lift Inspectors Association of South Africa |VA A0026 |15 March 2012 |

|12 |NSBE |National Society of Black Engineers |VA A0037 |12 June 2008 |

|13 |SAAMA |South African Asset Management Association |VA A0025 |14 May 2009 |

|14 |SACEA |South African Colliery Engineers' Association |VA A0005 |11 August 2011 |

|15 |SACMA |South African Colliery Managers Association |VA A0029 |24 January 2007 |

|16 |SAIAE |South African Institute of Agricultural Engineers |VA A0020 |11 August 2011 |

|17 |SAICE |South African Institution of Civil Engineering |VA A0006 |24 November 2010 |

|18 |SAIChE |South African Institution of Chemical Engineers |VA A0007 |11 August 2011 |

|19 |SAIEE |South African Institute of Electrical Engineers |VA A0008 |14 April 2011 |

|20 |SAIIE |Southern African Institute of Industrial Engineers |VA A0009 |11 August 2011 |

|21 |SAIMechE |The South African Institution of Mechanical Engineering |VA A0021 |14 April 2011 |

|22 |SAIMENA |South African Institute of Marine Engineers and Naval Architects |VA A0010 |11 August 2011 |

|23 |SAIMM |South African Institute of Mining and Metallurgy |VA A0011 |14 April 2011 |

|24 |SAIRAC |South African Institute of Refrigeration and Air-Conditioning |VA A0028 |24 January 2007 |

|25 |SAT |Society for Asphalt Technology |VA A0043 |26 August 2010 |

|26 |STE |Society of Telkom Engineers |VA A0035 |12 June 2008 |

| |Category B |

| |Acronym |Name |Reference |Date |

| | | |Number |Recognised |

|28 |SAID |South African Institute of Draughting |VA B0033 |30 November 2007 |

|29 |SAIMC |South African Institute of Measurement and Control |VA B0024 |11 August 2011 |

|30 |WISA |Water Institute of Southern Africa |VA B0038 |12 June 2008 |

| |Category C |

| |Acronym |Name |Reference |Date |

| | | |Number |Recognised |

|32 |BEPEC |Built Environment Professions Export Council |VA C0044 |24 November 2010 |

|33 |CESA |Consulting Engineers South Africa (p.n.a. SAACE) |VA C0013 |14 April 2011 |

|34 |IESSA |Illumination Engineering Society of South Africa |VA C0012 |11 August 2011 |

|35 |INCOSE |International Council of Systems Engineering |VA C0030 |24 January 2007 |

| | |(SA Chapter) | | |

|36 |IQSA |Institute of Quarrying Southern Africa |VA C0014 |11 August 2011 |

|37 |ITC |Institute for Timber Construction |VA C0015 |11 August 2011 |

|38 |SAFA |South African Flameproof Association |VA C0016 |26 August 2010 |

|39 |SAFCEC |South African Federation of Civil Engineering Contractors |VA C0017 |11 August 2011 |

|40 |SAFPA |South African Fluid Power Association |VA C0039 |26 November 2008 |

|41 |SAISC |South African Institute of Steel Construction |VA C0018 |11 August 2011 |

|42 |SAIW |South African Institute of Welding |VA C0034 |30 November 2007 |

|43 |SARF |South African Road Federation |VA C0042 |26 August 2010 |

|44 |SASTT |Southern African Society for Trenchless Technology |VA C0041 |26 August 2010 |

 Please note:  Proof of membership must be submitted. 

Engineering Council of South Africa 1/4/2016

|Application and Annual Fees |

|1 April 2016 to 31 March 2017 |

|(Vat included) |

Application Fees (VAT included) - see Note 1 re pro rata annual fees

1. Candidate Categories - See Note 3:

|Within one calendar year from the date of obtaining a qualification recognised |Later than one calendar year after the date of obtaining a qualification |

|for purposes of registration |recognised for purposes of registration |

|640.00 |1600.00 |

2. Foreign Qualification Assessment - See note 3:

|All applicants with foreign educational qualifications are required to have their qualifications assessed before applying for |1600.00 |

|registration | |

3. Professional & Registered Categories – See note 3:

|For Applicants with uninterrupted |For Applicants not registered |

|registration as a Candidate |in any of the Candidate categories |

|3190.00 |6370.00 |

4. International Register:

|Applicable only to persons already registered with ECSA who are applying for registration on the ECSA portions of the International |R 3190.00 |

|Registers. This is a once-off fee. No annual fees are payable. | |

Annual Fees (VAT included) – see Note 1 re pro rata annual fees

|Candidates (4) |Professional & Registered Categories |

|Partial Exemption |No Exemption |Partial Exemption |No Exemption |

|991.00 |1371.00 |2292.00 |3190.00 |

Notes:

1) Annual fees are payable by all persons registered for as long as they are registered with ECSA. In the first year a pro rata annual fee from the date of registration to the end of March will be raised. Thereafter annual fees are raised every year for the period April to March.

2) Payment details:

a. Banking details: Standard Bank Eastgate Branch, Branch Code 018505, Account No. 221285938. Swift code SBZAZAJJ.

b. The accepted methods of payment are cheque, credit card (Visa or MasterCard only), EFT or deposit made at any Standard Bank branch into ECSA’s bank account. No cash will be accepted at ECSA’s Offices.

c. Please do not send cheques by post. ECSA will take no responsibility for cheques lost in the post or intercepted.

3) No Applications will be considered until payment for the full application fee has been received.

4) Persons registered in the Candidate category for more than six (6) years pay the same annual fees as persons registered in the Professional category.

5) Appeals. When a person wishes to appeal, a fee equalling twice the amount of the application fee that was payable by the applicant when applying for registration, will be payable.

6) An Early bird discount is granted to Registered persons if their annual fees for April to March are paid on or before 30 April. The discount is R50 for candidates and R100 for Professionals, VAT inclusive.

7) In addition to the annual fees in arrear, an admin fee of R450 is payable when reinstating a registration within one year of cancellation. After one year of being cancelled persons will need to re-apply for registration.

8) Persons who will be residing outside the RSA borders for a year or longer should advise Accounts of their overseas postal address in order for VAT to be removed from their invoice.

9) Registered persons should be aware of the fact that their registrations will not be cancelled if they have not been able to obtain their CPD points within the required time. Should they on the other hand not pay their annual fees in time, and they have not made any arrangements with Accounts for an extension, their registrations will most definitely be cancelled. CPD queries must be taken up with CPD@ecsa.co.za.

10) Once the registration of Registered persons is cancelled due to non-payment, and reinstatement is requested within twelve months from cancellation, an admin fee of R450, in addition to the annual fees in arrears, is payable. After one year of being cancelled persons will need to re-apply for registration. The normal application fees would then be raised in addition to the annual fees still owing. The re-application process is fortunately much simpler than the original process.

11) Persons who will be residing outside the RSA borders for a year or longer should advise Accounts of their overseas postal address in order for VAT to be removed from their invoice. Invoices will still be emailed to that person.

12) Annual fees cannot be frozen whilst working abroad. The Registered person has two choices: continue paying annual fees whilst abroad; or request cancellation of registration. If the Registered person is planning to return to the RSA after a few years it would probably be cheaper and convenient not to cancel his or her registration. Should a person cancel his or her registration, an application for re-registration and the application fee awaits that person when wishing to re-register. In addition to that, if the person wishes to retain his or her old registration number, all annual fees from date of cancellation up to the current year are payable. If the person opts for a new registration number, he or she would only be required to pay the application fee, plus any possible fees owing for the year of cancellation and the current year’s annual fee.

13) Registered persons, if their employer is willing to pay ECSA’s annual fee for their employees, should advise Accounts of their employer’s official name and address plus VAT number for inclusion on the invoice.

14) Annual fees invoices can be sent to the employer directly for payment. If that is the arrangement, the Registered person will not receive an invoice. He or she would receive a statement of account, as evidence of the charge raised against the employer. Should the Registered person not agree with the charge, he or she should advise their employer not to pay the invoice. The Registered person must take up the wrong charge with Accounts and request a correction. Once the problem is resolved, Accounts will issue a revised invoice. Registered persons should not present the statement of account to the employer for payment. Employers do not pay on statement. They should already have the invoice.

15) The fee for persons between the ages of 55 and 70 who have been granted the retired dispensation will be R191.00 (VAT inclusive).

ENGINEERING COUNCIL OF SOUTH AFRICA

Private Bag X 691 Waterview Corner, 1st Floor,

BRUMA 2026 2 Ernest Oppenheimer Avenue

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Tel: (011) 607-9500 Bruma Lake Office Park

Fax: (011) 622-9295 BRUMA

Email: zimasa@ecsa.co.za Johannesburg

Website: ecsa.co.za 2198

DISABILITY REGISTER

Registration Number: ___________________________________________

Name & Surname: ______________________________________________

Disability is defined as: “Persons with disabilities including those who have long-term physical, intellectual or sensory impairments which in interaction with various barriers may hinder their full and effective participation in society on an equal basis with others”.

Do you have any disability (Please tick):

|Yes |No |

If yes, state nature of Disability:

____________________________________________________

NB: Completion of this form is necessary in order to accurately reflect disability statistics in terms of Government Policy.

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